It is regularly reported that creatine supplementation, when combined with heavy resistance training leads to enhanced physical performance, fat free mass, and muscle morphology [18-22]. A 2003 meta analysis  showed individuals ingesting creatine, combined with resistance training, obtain on average +8% and +14% more performance on maximum (1RM) or endurance strength (maximal repetitions at a given percent of 1RM) respectively than the placebo groups. However, contradicting studies have reported no effects of creatine supplementation on strength performance. Jakobi et al  found no effects of a short term creatine loading protocol upon isometric elbow flexion force, muscle activation, and recovery process. However, this study did not clearly state if creatine supplementation was administered concurrent with resistance training. Bemben et al  have shown no additional benefits of creatine alone or combined with whey protein for improving strength and muscle mass after a progressive 14 weeks (3 days per week) resistance training program in older men. These conflicting results can be explained by the possibility that the supplemented groups were formed by a greater amount of non-responders or even because creatine supplementation was administered on the training days only (3 times a week). This strategy has not been adequately tested as effective in middle aged and older men for maintaining post loading elevated creatine stores .
We can all pile on the pounds, just stay in the fast food lane, but it’s a nutrient-dense healthy diet, that will promote lean muscle development and size. In truth, muscular growth and building that brick house frame, can be harder to achieve than losing weight, and very frustrating. But we are here to help - follow our top 8 tips and you'll pack on lean muscle and size far more easily and be well on your way to achieving that physique you want.
Some of these medications that can harm the kidneys include cyclosporine (Neoral, Sandimmune); aminoglycosides including amikacin (Amikin), gentamicin (Garamycin, Gentak, others), and tobramycin (Nebcin, others); nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene); and numerous others.
Although creatine is a natural component of food, the amount of food required to supersaturate the muscle with PCr may not be feasible. For example, it could require 22 pounds of meat daily . If creatine monohydrate is proven to be a safe and effective ergogenic aid, creatine supplementation may be the simplest way to increasing muscle stores. It may be beneficial to avoid caffeine if taking creatine supplements. One study showed that caffeine diminished strength gains seen with creatine use .
Although creatine can be bought commercially as a standalone product it is often found in combination with other nutrients. A prime example is the combination of creatine with carbohydrate or protein and carbohydrate for augmenting creatine muscle retention  mediated through an insulin response from the pancreas . Steenge et al  found that body creatine retention of 5 g CM was increased by 25% with the addition of 50 g of protein and 47 g of carbohydrate or 96 g carbohydrate when compared to a placebo treatment of 5 g carbohydrate. The addition of 10g of creatine to 75 g of dextrose, 2 g of taurine, vitamins and minerals, induced a change in cellular osmolarity which in addition to the expected increase in body mass, seems to produce an up regulation of large scale gene expression (mRNA content of genes and protein content of kinases involved in osmosensing and signal transduction, cytoskeleton remodelling, protein and glycogen synthesis regulation, satellite cell proliferation and differentiation, DNA replication and repair, RNA transcription control, and cell survival) . Similar findings have also been reported for creatine monohydrate supplementation alone when combined with resistance training .
A: If your goal is the largest accrual of muscle mass possible then there may be some benefit to ingesting nutrients with a period of 30-60 minutes after your workout. Does this have to be a protein shake? No, but ideally it should be a meal lower in fat to enhance the digest rate of nutrients within the gastrointestinal tract. However, if you have just eaten a mixed macronutrient meal pre-workout then you should keep in mind that that meal is still likely digesting so there’s no need to throw down the weights after your last set and rush to your locker to slam a protein shake.
In young rats given creatine in the diet at 2% of the diet for eight weeks, supplementation appears to increase bone mineral density (BMD) in the lumbar spine with a nonsignificant trend to increase BMD in the femur. Despite the trend, the femur appeared to be 12.3% more resistant to snapping from mechanical stress associated with increased thickness. Menopausal rats (ovarectomized) experience similar benefits, as supplementation of creatine (300mg/kg) for eight weeks during ovarectomy is able to increase phosphorus content of the bone and other biomarkers of bone health, although bone stress resistance was not tested.
Discomfort can arise from other factors. Individuals who perform large numbers of repetitions, sets, and exercises for each muscle group may experience a burning sensation in their muscles. These individuals may also experience a swelling sensation in their muscles from increased blood flow (the "pump"). True muscle fatigue is experienced as a marked and uncontrollable loss of strength in a muscle, arising from the nervous system (motor unit) rather than from the muscle fibers themselves. Extreme neural fatigue can be experienced as temporary muscle failure. Some weight training programs, such as Metabolic Resistance Training, actively seek temporary muscle failure; evidence to support this type of training is mixed at best. Irrespective of their program, however, most athletes engaged in high-intensity weight training will experience muscle failure during their regimens.
Weight gain might be the most common side effect. “Creatine can cause your body to hold on to water by pulling fluid into your cells via osmosis,” says Bates. “It doesn't necessarily cause you to gain weight as fat, but it can increase edema, or water weight.” Also, muscle is denser than fat, so in some cases building muscle can increase body weight overall (even if you’re simultaneously burning fat).
After supplementation of creatine monohydrate (loading phase, followed by 19 weeks maintenance), creatine precursors are decreased by up to 50% (loading) or 30% (maintenance), which suggests a decrease in endogenous creatine synthesis during supplementation. This appears to occur through creatine’s own positive feedback and suppression of the l-arginine:glycine amidinotransferase enzyme, the rate-limiting step in creatine synthesis, as levels of intermediates before this stage are typically elevated by up to 75%.
"It's especially important to eat a carb- and protein-rich meal immediately after a workout," Aceto says. "Right after training, it turns out that your body is really lousy at taking carbohydrates and sending them down fat-storing pathways," he says. "So post-training, carbs will be sent down growth-promoting pathways instead." And when these carbs are combined with a protein source, you've got a strong muscle-feeding combination because carbohydrates help deliver the amino acids into muscles by boosting insulin levels. This anabolic hormone drives nutrients into the muscle cells and kick-starts the muscle-growth process.
If you’re the kind of person who shops for popular dietary supplements like protein or collagen powder, you’ve probably seen another popular bottle on the shelves: creatine. This supplement, which can be taken as a powder or liquid (and usually in some kind of healthy shake), is a staple in the bodybuilding community thanks to its ability to help you pack on muscle and work out longer and harder. (1) While creatine is generally considered safe — and is one of the most researched supplements out there (according to a review published in July 2012 in the Journal of the International Society of Sports Nutrition) — it is still a supplement, which means it’s not regulated by the Food and Drug Administration (FDA) and product claims don’t necessarily need to be substantiated (though the FDA can pull products that are found to be unsafe). (2,3)
The specific mechanism of intestinal uptake for creatine is not clear, although transporters have been identified in rat jujenum, and confirmed at the mRNA level in humans. The observation that creatine can be absorbed against a concentration gradient to a max ratio of 8:1 (8 times more creatine in the intestinal cell post absorption, relative to the lumen) supports transporter-mediated uptake, and the dependence on sodium and chloride implicate SLC6A8 (Creatine Transporter 1) as the operative transporter.
Creatine has been noted to increase the amplitude (0.5-5mM) and frequency (25mM only) of NMDA receptors, although concentrations of 0.5-25mM also reduced signaling intensity. This was credited to creatine causing an increase in ligand binding of glutamate with an EC50 of 67µM and maximal activity at 1mM creatine (158±16% of baseline). Creatine appears to modulate the polyamine binding site of the NMDA receptor, as it is abolished by arcaine and potentiated by spermidine. This binding site is known to modify NMDA receptor affinity.
Collectively the above investigations indicate that creatine supplementation can be an effective strategy to maintain total creatine pool during a rehabilitation period after injury as well as to attenuate muscle damage induced by a prolonged endurance training session. In addition, it seems that creatine can act as an effective antioxidant agent after more intense resistance training sessions.